Edema - is a standard Thai foot massage to be avoided?

[NewGuy]

Hi all,

I've got mild swelling in one foot and both ankles (it has been more pronounced). Anyway, my favorite Thai foot massage place is great but I doubt if the staff has heard of manual lymphatic drainage.

Can I keep up my regime of two or three sessions a week?

[Sheryl]

A Thai foot massage will have the effect of encouraging lymphatic drainage. Certainly no need to avoid them due to edema, though you would be wise not to let them "crack" your toes as this sometimes causes injury.

Simply sitting or lying with your legs elevated will also promote lymphatic drainage.

I assume the cause of the edema is known and is being addressed?

[NewGuy]

Thanks Sheryl. For causes, there are lots of possibilities. When I tell my doc about the swelling, that's the day without edema and he tells me "not too bad". I ask why there are blotchy patches of a purple-like hue - basically, I shouldn't worry.

I'll take iPad photos of my next few episodes to give him more to work on.

[dddave]

You might try compression stockings to alleviate the problem but I suggest you find a Doctor willing to delve deeper into the cause. Edema is not a trivial condition.

[Sheryl]

Do you have heart disease or other known chronic health problem?

[NewGuy]

Here we go: type 2 diabetes, 20+ years, HbA1C good, thanks metformin; AFIB, 8 years, now under control, amiodarone, 1 year; Angiogram showed the need for statins but not stents, 2.5 years - Total, LDL cholesterol just went low, reduced statin dose; Bosniak II cyst in right kidney, removal needed if future problems, 4+ years; COPD, 'medium' - was 'mild' when first diagnosed 2.5 years ago, lots of inhalers, NAClong, had pneumonia, acute bronchitis x2, lots of inoculations; liver numbers rising, alcohol being lowered.

For me, those are the biggies, haha. Oh yeah, much reduced edema after foot massage!

[Sheryl]

OK. I asked because your doctor's response makes sense only if there was already a known cause for the edema.

Congestive heart failure would be one such but, while you have problems which can lead to it, it does not sound from what you say that it is thought to be present now. Worth asking your doctor about, however.

You might also consider consulting a vascular specialist in case there is a circulatory problem related to your diabetes.

Improvements after massage will be temporary.

[NewGuy]

Thanks again Sheryl. Could you recommend a vascular specialist at BPD or Bumrungrad? I've been seeing Dr. Ularn in Pattaya, for heart thingies.

[DogNo1]

Personally, I like Dr. Sukitti at Bumrungrad. He is always positive and helpful. I've had six stents installed at Bumrungrad. Please be aware that athersclerosis has other causes besides high LDL cholesterol. Thinking is changing about lipidemia (high cholesterol) as a cause of heart disease. You might want to read some of the recent articles in the NYT. Also spacedoc.org is a good resource. Good luck!

[andrew55]

As dddave has suggested previously, compression bandages can be very useful. I'm told they can be quite uncomfortable.

To be most effective they need to be made for you. I have no idea where to source them. Sheryl?

Have you had episodes of Lymphangitis? You need to be very careful to avoid even scratching yourself and avoid infection. If this does occur don't be shy with the antibiotics at the earliest suspicion.

I worry about hospitals. Golden Staph. would not be good for you. ( Edit - I think Strep. is the usual kick-off for the acute condition?)

I am not a medico so I guess I shouldn't have given my thought re: antibiotics. However, I haven't deleted it. I do have some field experience.

I wish you well.

Edited May 3, 2016 by andrew55

[Sheryl]

Thanks again Sheryl. Could you recommend a vascular specialist at BPD or Bumrungrad? I've been seeing Dr. Ularn in Pattaya, for heart thingies.

Sorry for delayed response, I needed to do some research.

Actually the best doctor to see is at Siriraj, you ought to be able to see him privately at their private wing http://www.siphhospital.com/ :

Prof. Nuttawut Sermsathanasawadi

If you really prefer to stay with Bumrungrad then could try either of these:

https://www.bumrungrad.com/doctors/Kritaya-Kritayakirana

https://www.bumrungrad.com/doctors/Piyanut-Pootracool

A problem such as you describe is usually due either to vascular insufficiency (which can be related to diabetes, and puts one at risk for diabetic foot ulcers) or to congestive heart failure. I am assuming from what you say, and that you are under a cardiologist's care, that your heart disease is under control and you are not in CHF hence suggestion to see a vascular doc. They may need to do an ultrasound of the veins in your leg.

[NewGuy]

Wow, great tips and research everybody, very specific.

On my next trip to the Big Mango I'll probably choose Siriraj, if I can figure how to cross the Chao Praya, haha.

[marcusd]

Thanks again Sheryl. Could you recommend a vascular specialist at BPD or Bumrungrad? I've been seeing Dr. Ularn in Pattaya, for heart thingies.

Sorry for delayed response, I needed to do some research.

Actually the best doctor to see is at Siriraj, you ought to be able to see him privately at their private wing http://www.siphhospital.com/ :

Prof. Nuttawut Sermsathanasawadi

If you really prefer to stay with Bumrungrad then could try either of these:

https://www.bumrungrad.com/doctors/Kritaya-Kritayakirana

https://www.bumrungrad.com/doctors/Piyanut-Pootracool

A problem such as you describe is usually due either to vascular insufficiency (which can be related to diabetes, and puts one at risk for diabetic foot ulcers) or to congestive heart failure. I am assuming from what you say, and that you are under a cardiologist's care, that your heart disease is under control and you are not in CHF hence suggestion to see a vascular doc. They may need to do an ultrasound of the veins in your leg.

The type 2 diabetes is a sure as hell fire contributor too if you have has TYPE 2 FOR more than 5 years

[arjunadawn]

Think your a lucky guy in this regard: I continue to be amazed by one of our members, Sheryl. No kidding. I have rarely found a poster's information to be so consistently helpful and posted with compassion. I was once again impressed by this in this thread.

As you no doubt have been told, be wise and thoughtful about your feet. Feet are consistently a big problem for folks such as yourself. Scratches, cleanliness, upkeep, nail trim, fungal, tight shoes, too much standing, etc., all have to be considered in your daily hygiene/maintenance. I would offer one tip: If you want to get a foot massage and when you squeeze the toe it takes a long time, like ^5 sec to turn red again, perhaps you might postpone the massage and instead just elevate the feet that day. If you depress your foot with the thumb and the indent remains a long time, perhaps postpone a massage. One of the difficulties for people with DM is the micro/small vessels being easily damaged. I wish you good health.